title: Neurocognitive changes in depressed patients in psychodynamic psychotherapy, therapy with fluoxetine and combination therapy.
abstract: BACKGROUND
  Randomized controlled trials (RCTs) examining the efficacy of different forms of therapy for depression are relatively common. However, there are not many RCTs comparing neurocognitive effects of these treatments. Neurocognitive changes across three types of treatment for depression were compared. Long-term psychodynamic psychotherapy (LTPP) was compared with fluoxetine treatment, and their combination, in the treatment of moderate depression.
  
  
  METHODS
  A 272 adult patients with beck depression inventory (BDI) scores 20-35 were randomized to receive LTPP, fluoxetine monotherapy or their combination for a 24 months period. The Wechsler adult intelligence scale version III (WAIS-III) was the primary neuropsychological measure.
  
  
  RESULTS
  Multilevel mixed model analyses indicated that there were neurocognitive changes within and between treatments, with statistically significant differences over time (p>.01). LTPP and combined treatment seemed to be more efficacious in modifying specific areas of cognition than fluoxetine alone.
  
  
  CONCLUSIONS
  Sample very homogenous, threatening external validity.
  
  
  CONCLUSIONS
  LTPP and its combination with fluoxetine demonstrated to be effective for specific neurocognitive increasing in patients with moderate depression. This study suggests marked differences over time in the neurocognitive effects between the three treatment forms compared. Results found here may be of clinical relevance for building bridges between pharmacotherapy and psychodynamic psychotherapy.
authors.affiliation: Federal University of Rio Grande do Sul, Brazil; Contemporary Institute of Psychoanalysis and Transdisciplinarity of Porto Alegre, Brazil. Electronic address: andregbastos@gmail.com.
authors.forename: Andre Goettems
authors.initials: AG
authors.lastname: Bastos
authors.forename: Luciano Santos Pinto
authors.initials: LS
authors.lastname: Guimarães
authors.forename: Clarissa Marceli
authors.initials: CM
authors.lastname: Trentini
mesh_terms: D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D003071:Cognition; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011581:Psychological Tests; D064889:Psychotherapy, Psychodynamic; D014888:Wechsler Scales
chemical_list: D018687:Antidepressive Agents, Second-Generation; D005473:Fluoxetine
keywords: Cognition; Depression; Fluoxetine; Long-term psychodynamic psychotherapy